Ask a care manager: Out loud admissions and trust

By From page A5 | January 16, 2013

It can be very difficult to get to a point in your life when you recognize that you can’t do it all yourself.

It may be as simple as getting down on your hands and knees to look under the table or as complex as solving an automotive problem that in prior years you were able to repair yourself.

For some, it is as hard to admit the shortcoming as it is to say out loud, “I need some help with this.”

Once it’s out in the open, this vulnerability to admitting we need help, seems a bit closer to solving.

Getting a grandchild to retrieve that item from under the table and locating a good mechanic are the coping mechanisms we use when we come upon tasks we can no longer accomplish.

It doesn’t mean we aren’t completely capable in other ways but there are limitations.

What happens when we begin looking for solutions and then don’t know what the exact solution is, don’t know where to look for it, and don’t know who to trust?

It’s particularly important when the issue centers on a person and their life.

Some examples follow

My wife and I are in our mid 80s. We’ve never had children and are independent in our own home. Although we both have some health issues, we are managing quite well. We worry, however, about what will happen as our health declines. We have specific ideas of what we want but don’t know where to start. What should we do?

Finding trusted advisors is always the best place to start when planning for your life.

Trust is defined as reliability, truth, integrity and strength of character of someone or something. If the advisor has appropriate credentials i.e., an attorney well regarded in the community and expertise in the type of law you need, you should be able to develop a trust relationship.

The same holds true for a banker, CPA/accountant and other credentialed professionals such as geriatric care managers whose expertise is assistance with life planning for older adults.

My mother has agreed to have someone come in to help with my father’s care. He has Parkinson’s disease, gets easily confused and can’t be left alone. I live out of town but have a list of home care companies and a list of individuals who will work for my parents. My mother wants to hire a neighbor who will work for less money. I have a concern about trusting anyone in the house with my father alone. What should I tell my mother?

Remember trust means, “reliability, truth, integrity and strength of character.”

There are legalities that must be followed if you hire anyone privately along with questions of education and training. What does this person know about Parkinson’s disease? Do you know them well enough to feel they are telling the truth? Are they honest?

Talk to others in the community to see which agency is the best, has the best reputation, is the most reliable and talk to them about helping you decide what would help and be cost effective as well.

My wife is not well and sleeps only a few hours during the night. I get up to help her so I am not getting any sleep, either.

I want to talk this over with my son when he stops by but he’s always in a hurry. I’m worried that my own health is getting worse. I’m unsure how much longer I can keep this up. Who can help me?

Your wife’s doctor may be able to help. Try and remember when the sleepless nights began. Did she have a change in her medications? Did you buy new pillows? Is she eating or drinking liquids just before bed?

Make an appointment for her and go in with her giving the doctor all the information you can to help. Even if it’s a long standing problem, the doctor may be able suggest a solution or an alternative medication without that side effect.

Talking to your son is important, too.

Ask him next time he stops by if he could come over for a talk and stay a bit longer to talk about what’s going on caring for his mother. Include him in the ongoing conversations so he’ll continue to feel a part of the decisions but he also may be able to help by spending the night once a week so you can get a good uninterrupted night’s sleep.

We live on a fixed income and are already worried about outliving our savings. I hate to spend money on someone coming into help so we are doing it by ourselves. How will I know when it’s time to get help one way or another? How do I know how much “it” costs? What’s out there for us?

My mother had a favorite saying: “The Lord helps those that help themselves.” I think all of us keep thinking we can do it all until one day, we can’t.

You’re lying in a hospital bed after a broken hip thinking I knew I should have built that ramp years ago.

We each have our own version of our crystal ball but planning doesn’t cost anything and can help avert a tragedy. So remember the “trust factor” and begin collecting information on whom to trust with what and set it up so you have it when you need it. Be wary of anyone or anything that isn’t “tried and true.”

Cost? Shop by phoning and ask. Tell the company what you’re looking for. Review their Website, what other customers say about them, how long they’ve been in business and ask for references.

Compare the costs with those of retirement facilities, assisted living facilities and skilled nursing homes.

Consider sitting down with a credentialed geriatric professional to consult and answer the questions you have in front of you.

Talk to your doctor or nurse practitioner about who to talk with.

Try out an agency. Let them know you’re planning ahead when you will need help. Hire them for 2 weeks, 2 times a week. See who they send, how trained the person is, how helpful and honest they are, how they bill, if their staff is trained, if they send a knowledgeable person to do the home visit, etc.

Ask if you can use them on an “as needed” basis.

By doing some work ahead of time, you’ll be better prepared.

My children and I don’t get along and they live a distance from me. What kind of legal documents should I have to make sure my wishes are followed? Who should I choose to help me when I need it?

It can be very difficult if there has been no planning around who’s in charge if you can’t be.

The doctors and the hospital need someone to tell them how to treat you (if you’re unable to tell them yourself). The bills need to be paid. Someone needs to feed and care for your old dog or cat that is wondering where you are.

Someone needs to physically help you should you need help or make decisions in your best interest should your memory fail.

Deciding on whom to trust with these important decisions is crucial to you and your life. Deciding and talking to a good friend or two can help if they agree to be your agent with Powers of Attorney for healthcare and finances (two separate documents).

Getting these signed with copies to family, your physician and local hospital can help greatly. Deciding who will take the dog or cat either until you recuperate or as their new owner can give you relief when you’re unable to care for them.

Decisions such as these are not easy and shouldn’t be made lightly. Taking the time to think about how you live your life, how you’d like to continue and who you trust to be involved can make the difference between quality of life and life as existence.

Look to the ones you trust.

Carol S. Heape, MSW, CMC is executive director/CEO of Elder Options Inc., a geriatric care managed home care agency serving the Sacramento region with offices in Placerville and South Lake Tahoe,

Carol Heape


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